Accelerated Osteogenic Orthodontics Treatment Does Not Result In Significantly Different Density Of The Periodontium Compared To Conventional Orthodontics

Clinical Question

In patients requiring orthodontics, how does the use of accelerated osteogenic orthodontics affect the post-treatment density of the periodontium when compared to conventional orthodontics?

Clinical Bottom Line

The post-treatment density of the periodontium is not significantly different between patients treated by accelerated osteogenic orthodontics compared to conventional orthodontics. Moreover, there is no statistically significant difference in bone density between the two treatment groups. The use of accelerated osteogenic orthodontics has been shown to decrease the duration of orthodontic treatment by increasing the velocity of tooth movement. However, this intervention requires treatment by a specialist (such as an oral surgeon) and is not a practical procedure to be adopted by a general dentist.

This study was a systematic review of several surgical techniques linked to decreasing orthodontic treatment time. The review analyzed various accelerated osteogenic orthodontic therapies and assessed the velocity of movement, biological mechanisms, and complications of each treatment. The post-treatment density of the periodontium is not significantly different between patients treated by accelerated osteogenic orthodontics compared to conventional orthodontics. Assessment of periodontium osteoclastic and osteoblastic activity post-treatment showed no statistically significant difference between the two treatment groups. Moreover, none of the studies showed any statistically significant difference in bone density between the two treatment groups. The use of accelerated osteogenic orthodontics has been shown to decrease the duration of orthodontic treatment by increasing the velocity of tooth movement. However, this intervention would require treatment by a specialist (such as an oral surgeon) and is not a practical procedure to be adopted by a general dentist.

Validity: The study design used to research this topic is a systematic review. However, the systematic review is on animal studies, and although closely matched dentally, they differ by species and breeds across studies.
Perspective: The PICO question posed was in the TREATMENT category. This question is relevant within the field of orthodontics, oral surgery, general dentistry, and pediatric dentistry. This is a relatively new concept within the field of dentistry, and more research is needed to provide more definite answers relating to bone density.

Applicability

The subject pool discussed in the systematic review was not representative of the patients that would be seen in a general dentistry practice because these subjects were animals.
In general, this treatment option would not be feasible in a general practice or orthodontic setting. This treatment would be more applicable in an oral surgery setting PLUS an orthodontic/general practice setting. For that reason, osteogenic accelerated orthodontic therapy may not be an attractive option for patients because of the need to engage multiple specialists.
In conclusion, the use of corticotomy-facilitated orthodontics is not a superior treatment option compared to traditional orthodontics in regard to decreasing bone resorption as a result of orthodontic therapy.

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